Active NPI
Jonathan Redic, CRNA
- Certified Registered Nurse Anesthetist
- Little Rock, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- C003222
- Practice address
- 2 Saint Vincent Cir
Little Rock, AR 72205-5423 - Phone
- (501) 664-4532
- NPI assigned
- Jan 17, 2018
- Last updated
- Apr 13, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | C003222 | AR | Primary |
Addresses
Primary practice location
2 Saint Vincent Cir
Little Rock, AR 72205-5423
Mailing address
500 S University Ave Ste 500
Little Rock, AR 72205-5307
Phone (501) 664-4532
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone (501) 552-4666
2215 Wildwood Ave
Sherwood, AR 72120-5089
Phone (501) 552-7100
7709 Hwy 107
Sherwood, AR 72120-4661
Phone (501) 552-7269
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Vincent Medical Group | Current | Accepting new patients | |
| Southern Regional Anesthesiology Consultants PLLC | Current | Accepting new patients | |
| Etherco Anesthesia PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888
2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680
500 S University Ave
Ste 500
Little Rock, AR 72205
Phone (501) 320-1101
6119 Midtown Ave
Ste 201
Little Rock, AR 72205
Phone 5016644532113
4 Hospital Dr
Morrilton, AR 72110
Phone (501) 977-2300
7005 S Hazel St
Pine Bluff, AR 71603
Phone (870) 536-3070
2215 Wildwood Ave
Sherwood, AR 72120
Phone (501) 522-7100
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Little Rock, AR
- NPI 1134176480
-
- Certified Registered Nurse Anesthetist
- Pine Bluff, AR
- NPI 1922838523
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Little Rock, AR
- NPI 1902231673
-
dba BRMC Anesthesia
- Anesthesiology Physician
- Mountain Home, AR
- NPI 1114178753
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St. Vincent Medical Center - North
- General Acute Care Hospital
- Sherwood, AR
- NPI 1629011002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586736000000",
"number": "1265940878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S UNIVERSITY AVE STE 500",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722055307",
"telephone_number": "501-664-4532",
"fax_number": "501-663-4335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 SAINT VINCENT CIR",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722055423",
"telephone_number": "501-664-4532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDIC",
"first_name": "JONATHAN",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-17",
"last_updated": "2020-04-13",
"certification_date": "2020-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AR",
"license": "C003222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.